Gynaecologic and Minimally Invasive Surgery

Surgical methods

Hysteroscopy

Hysteroscopy is a minimally invasive procedure that allows a gynaecologist to examine the inside of the uterus to diagnose or treat a variety of conditions.

Depending on your needs, the procedure may be done using local, regional or general anesthesia. It can often be performed in our medical office without sedation.

A thin tube called a hysteroscope is inserted through the vagina and into the uterus. The hysteroscope contains a small camera, a light and a surgical instrument. Images from the camera appear on a screen so your gynaecologist can see inside your uterus. Often, the instrument can be used to perform minor procedures at the same time.

Hysteroscopy is used to diagnose or treat a variety of conditions, including endometrial polyps and submucosal fibroids.

Laparoscopy

Laparoscopy is a minimally invasive surgical procedure that allows a surgeon to access the abdomen or pelvis through small incisions.

The procedure has a shorter recovery period than traditional open surgery (laparotomy). You can usually go home the same day.

You will be put to sleep under general anesthesia for this procedure. A thin tube containing a camera is then inserted through a small incision near your belly button or just below your rib cage. The camera sends images to a screen so your surgeon can see the inside of your abdomen and pelvis. Surgical instruments are inserted through fingernail-sized incisions to perform the procedure.

Laparoscopy is used for a variety of procedures, including surgery for endometriosis, fibroids, ovarian cysts, removal of fallopian tubes or ovaries, and removal of the uterus (hysterectomy).

Laparotomy

Laparotomy is an open surgical procedure that allows a surgeon to access the abdomen or pelvis through an incision similar to those used in Caesarean sections. The procedure is done under general anesthesia and requires a hospital stay and a longer recovery time compared with minimally invasive procedures.

Laparotomy may be recommended when minimally invasive surgery is not possible or for other reasons. Laparotomy is used to perform a variety of procedures, including myomectomy (fibroid surgery), removal of the uterus (hysterectomy) and surgery to treat advanced endometriosis.

Robotic surgery

Robotic surgery is another type of laparoscopic surgery that uses a robotic device. It is used for specific types of procedures, such as reconstructive surgeries, or to treat complex health or pelvic disorders like high BMI.

You will be put to sleep under general anesthesia. Compared to traditional open surgery (laparotomy), robotic surgery has a shorter recovery period.

During robotic surgery, small instruments and a camera are inserted through small incisions in your abdomen. The camera sends images to a screen, allowing a surgeon to see inside your abdomen and pelvis. The surgeon controls the robotic instruments and can perform complex procedures with precision.

Robotic surgery may be used to remove fibroids, for some hysterectomies, or to perform other gynaecological procedures.

Types of surgery

Endometriosis surgery

Surgery for endometriosis can provide temporary symptom relief or help with fertility.

Laparoscopy is the most common method of surgery for endometriosis. During the procedure, a surgeon will access your abdomen and pelvis using small incisions and remove endometrial tissue growing outside the uterus.

Surgery cannot cure endometriosis, but it is often very helpful.

Medical treatment may be needed to continue managing endometriosis after surgery.

Myomectomy

Myomectomy is surgery to remove uterine fibroids. It is often recommended if you want to preserve your fertility.

Depending on symptoms and the size and location of fibroids, different removal methods may be recommended.

Smaller fibroids can be removed using minimally invasive methods such as hysteroscopy, laparoscopy and robotic surgery. Open surgery (laparotomy) may be required in certain circumstances.

Hysterectomy

Hysterectomy is the surgical removal of the uterus.

Hysterectomy may be recommended as the primary treatment for some conditions, or when medication or other treatments have not been effective.

A hysterectomy can treat a variety of conditions, including adenomyosis, fibroids, endometriosis or cancer.

There are several types of hysterectomy. Our surgical team will discuss the risks and benefits and help you decide which option is best for your needs.

Most of the time, the cervix is removed along with the uterus. However, there are specific situations when the cervix is preserved.

Depending on your needs, the ovaries and fallopian tubes may be preserved or removed along with the uterus. If you are premenopausal and have your ovaries removed, it will bring on menopause.

Hysterectomy can be performed using different methods. Our surgical team will consider your individual condition and surgical history when recommending a method.

Sometimes, the uterus can be removed through the vagina without the need for any external incisions. In other cases, we may recommend a laparoscopy or open surgery (laparotomy).

Pelvic nerve (neuropelveology) surgery

Pelvic nerve surgery is a specialized procedure used to relieve symptoms caused by conditions involving the pelvic nerves.

These conditions include advanced endometriosis, compressed pelvic nerves, benign nervous system tumours called schwannoma and others.

Mount Sinai Hospital is the only hospital in Canada specializing in this type of surgery.

Our surgeon uses a minimally invasive method called laparoscopy to access and treat the nerves in the pelvis through small incisions.